Individual provider Active NPI

Selin Sureyya Kepkep, PH.D.

  • Clinical Psychologist
  • Hopkinton, MA
National Provider Identifier
1477791168
Registry record updated Dec 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7329 Issued in MA
Practice address
1 Ash St
Hopkinton, MA 01748-1886
Phone
(781) 987-2089
NPI assigned
Feb 3, 2009
Last updated
Dec 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 7329 MA Primary

Addresses

Primary practice location

1 Ash St
Hopkinton, MA 01748-1886

Mailing address

58 Adams Cir
Northbridge, MA 01534-1087
Phone (774) 573-8505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110920000668 MA Practitioner - Clinical Psychologist 2365613585

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Psychological Services, PLLC Clinical CurrentSince May 1, 2021 Accepting new patients
FCP, Inc Past Accepting new patients

Locations

1 Ash St
Hopkinton, MA 01748
Phone (508) 254-9142

221 E Main St
Milford, MA 01757
Phone (508) 473-7599

89 Access Rd
Ste 24
Norwood, MA 02062
Phone (781) 336-5040

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1233619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671148800000",
    "number": "1477791168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 ADAMS CIR",
            "city": "NORTHBRIDGE",
            "state": "MA",
            "postal_code": "015341087",
            "telephone_number": "774-573-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ASH ST",
            "city": "HOPKINTON",
            "state": "MA",
            "postal_code": "017481886",
            "telephone_number": "781-987-2089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEPKEP",
        "first_name": "SELIN",
        "middle_name": "SUREYYA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-03",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopkinton, MA

Sources for this page

Verify at the official NPI Registry.